J Korean Soc Radiol.  2017 Dec;77(6):412-415. 10.3348/jksr.2017.77.6.412.

Ileal Heterotopic Gastric Mucosa with Small Bowel Obstruction Mimicking Inflammatory Bowel Disease: A Case Study

• Cho JY
• Woo JY
• Hong HS
• Yang I
• Moon JH
• Hwang JY
• Kim HM
• Kim HY
• Kim HJ
• Kim JW

• KMID: 2396500
• DOI: http://doi.org/10.3348/jksr.2017.77.6.412

Abstract

Gastric heterotopia rarely occurs in the ileum without a Meckel's diverticulum. We report a case of a 53-year-old man who presented with recurrent abdominal pain. The initial computed tomography (CT) scan showed circumferential wall thickening and stricture of the ileum. At the follow-up examination (8 months), previously observed circumferential wall thickening and stricture were more aggravated, causing small bowel obstruction. The patient underwent small bowel resection and the histopathology was consistent with ectopic gastric mucosa. We suggest that the rare CT findings were indicative of ileal gastric heterotopia which have never been reported. Based on these CT findings, our differential diagnosis excluded inflammatory bowel disease.

MeSH Terms

Abdominal Pain
Constriction, Pathologic
Diagnosis, Differential
Follow-Up Studies
Gastric Mucosa*
Humans
Ileum
Inflammatory Bowel Diseases*
Intestinal Obstruction
Meckel Diverticulum
Middle Aged
Multidetector Computed Tomography

Figure

• 

  Fig. 1. Heterotopic gastric mucosa in ileum of 53-year-old man. A. A contrast-enhanced axial CT scan shows focal circumferential wall thickening of the ileum (length of involvement = 3.5 cm; arrows). Associ-ated luminal stricture is suggested. B, C. A contrast-enhanced axial CT scan (B) shows circumferential wall thickening of the ileum (arrows) after eight months. The luminal stricture is aggravated. A coronal CT scan (C) shows distended proximal small bowel with multiple air fluid-levels. D-F. There are two circular ulcerated lesions (arrows) in the small intestine (D). There is an ulcer (arrow) involving the submucosa and proper muscle. The submucosa and muscle layer are fibrotic and thickened (E, H& E, × 10). The gastric epithelium with surface foveolar epithelium and pyloric glands is identified next to the ulcer. Oxyntic glands, including parietal (arrowheads) and chief cells (asterisk), are also present (F, H& E, × 100, × 400). H& E = Hematoxylin and eosin stain

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